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INCIDENCE AND SEVERITY OF UPPER EXTREMITY HIGH SCHOOL FOOTBALL TRAUMA ON ARTIFICIAL VERSUS NATURAL GRASS

Abstract

K.M. Miller, M.C. Meyers, FACSM, D. Moffit, and K. M. Shuman.

Idaho State University, Pocatello, ID

In the past, serious injuries have been attributed to playing on artificial turf. Although newer generations of artificial turf have been developed to duplicate the playing characteristics of natural grass, no long-term studies have specifically compared articular and muscle trauma of the upper extremity between the two surfaces. PURPOSE: To quantify incidence, mechanisms, and severity of game-related upper extremity high school football injuries on artificial turf versus natural grass. METHODS: 19 high schools were evaluated over 9 competitive seasons for injury incidence, injury category, time of injury, injury time loss, player position, injury mechanism and situation, primary type of injury, grade and anatomical location of injury, type of tissue injured, elective imaging and surgical procedures, and environmental factors. RESULTS: Of the 433 high school games documented, 239 team games (55.2%) were played on artificial turf versus 194 team games (44.8%) played on natural grass. A total of 239 upper extremity injuries were documented with 123 (51.5%) occurring on artificial turf, and 116 (48.5%) on natural grass. Univariate analyses per 10 team games indicated no significant injury incidence effect (p > 0.05), between surfaces by severity level, either in minor injury incidence rates (IIRs), 4.1 (95% CI, 3.5-4.7) versus 4.3 (95% CI, 3.6-5.0), in substantial IIRs, 0.7 (95% CI, 0.4-1.1) versus 1.2 (95 % CI, 0.8-1.8), or in severe IIRs, 0.4 (95% CI, 0.2-0.7) versus 0.5 (95 % CI, 0.2-0.9) documented on artificial turf when compared to natural grass, respectively. Analyses indicated a significant playing surface effect (p > 0.05) by position played at the time of injury (special teams); [0.5 (95% CI, 0.3-0.9) vs 0.0 (0.0-0.0)], and primary type of injury (contusions; [0.9 (95% CI, 0.7-1.4) vs 2.6 (2.1-3.3)], while competing on artificial turf versus natural grass, respectively. No significant surface effects on upper extremity trauma were observed in injury category, injury grade, player position, injury mechanism and situation, injury time loss, elective imaging and surgical procedures, environmental factors, type of tissue or across specific joint and muscle. CONCLUSION: Since minimal differences existed between artificial turf and natural grass during game-related play over a 9-year period of competitive play, artificial turf is a practical alternative when comparing upper extremity injuries in high school football. It must be reiterated that the findings of this study may be generalizable to only high school football competition and this specific artificial surface.

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